Understanding changes in complex care needs over time: key research insights into multimorbidity trajectories
The Lancet Healthy Longevity, vol. 6, pp. 100790
Abstract
Multimorbidity, the coexistence of multiple chronic diseases or conditions, poses a major challenge for health-care systems worldwide. Traditional research has largely relied on cross-sectional studies, offering limited insight into multimorbidity evolution over time. This Personal View advocates for a paradigm shift towards longitudinal approaches that capture multimorbidity trajectories. Tracking the sequence, pace, and severity of disease accumulation can enhance our understanding of underlying mechanisms, inform early interventions, and improve patient care. Drawing on expert discussions from an international workshop held in Bielefeld, Germany, in May, 2024, we outline key themes and findings to guide future research on the dynamic processes underlying multimorbidity trajectories. Specifically, we summarise previous work, examine the challenges and opportunities of existing data resources, and highlight priority areas for further investigation. Advancing this field will require the standardisation of longitudinal multimorbidity phenotypes, integration of health and social care processes, and testing the usefulness of trajectories for patient-relevant outcomes and risk stratification. Progress will also depend on methodological innovation, patient and public involvement, harmonisation of diverse data sources, and close interdisciplinary collaboration. Ultimately, a trajectory-based framework for multimorbidity research can enable more personalised, efficient, and equitable health-care strategies, improving outcomes in ageing populations.
Authors 23
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Amaia Calderón‐Larrañaga corresponding
Stockholm University · Karolinska Institutet
Affiliation as printed
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden. Electronic address: amaia.calderon.larranaga@ki.se
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Affiliation as printed
Department of General Practice and Family Medicine, Medical School OWL, University Bielefeld, Bielefeld, Germany
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Affiliation as printed
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Affiliation as printed
Institute of General Practice, Goethe University, Frankfurt am Main, Germany
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Affiliation as printed
Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK
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National University Health System
Affiliation as printed
Department of Family Medicine, National University Health System, Singapore; Centre for Research in Health System Performance (CRiHSP), Yong Loo Lin School of Medicine, Singapore
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Stockholm University · Karolinska Institutet
Affiliation as printed
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Affiliation as printed
Department of General Practice and Family Medicine, Medical School OWL, University Bielefeld, Bielefeld, Germany
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Stockholm University · Karolinska Institutet · Stockholm Gerontology Research Center Foundation
Affiliation as printed
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
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Martin Luther University Halle-Wittenberg
Affiliation as printed
Institute of Health, Midwifery and Nursing Science, Medical Faculty of Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
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Affiliation as printed
Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
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Leiden University Medical Center
Affiliation as printed
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
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Affiliation as printed
Department of General Practice and Family Medicine, Medical School OWL, University Bielefeld, Bielefeld, Germany
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Affiliation as printed
Department of General Practice and Family Medicine, Medical School OWL, University Bielefeld, Bielefeld, Germany
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Affiliation as printed
Institute of General Practice, Goethe University, Frankfurt am Main, Germany
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Universität Hamburg · University Medical Center Hamburg-Eppendorf
Affiliation as printed
Department of General Practice and Primary Care, University Medical Center Hamburg, Germany
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University of California, San Francisco
Affiliation as printed
Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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University of Eastern Finland · Netherlands Institute for Health Services Research
Affiliation as printed
Nivel (Netherlands Institute for Health Services Research), Utrecht, Netherlands; University of Eastern Finland, Department of Health and Social Management, Kuopio, Finland
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St. Michael's Hospital · Unity Health Toronto
Affiliation as printed
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
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Affiliation as printed
Department of Public Health and Primary Care, Trinity College Dublin, Ireland
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Affiliation as printed
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
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Affiliation as printed
Department of General Practice and Family Medicine, Medical School OWL, University Bielefeld, Bielefeld, Germany
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Goethe University Frankfurt · Maastricht University · KU Leuven
Affiliation as printed
Institute of General Practice, Goethe University, Frankfurt am Main, Germany; Department of Family Medicine, Maastricht University, Maastricht, Netherlands; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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